Lai, N.M., Lai, N.A., O'Riordan, E., Chaiyakunapruk, N., Taylor, J.E., & Tan, K. (2016). Skin antisepsis for reducing central venous catheter-related infections. Cochrane Database of Systematic Reviews, 7, CD010140.
STUDY PURPOSE: To evaluate skin antisepsis in reducing catheter-related bloodstream infections (BSIs), catheter colonization, morbidities, and mortality
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Not specified or not applicable
Analysis of chlorhexidine versus povidone iodine showed a relative risk of 0.064 (p = 0.05) in favor of chlorhexidine for the outcome of BSI. No significant difference existed between these two methods for all-cause mortality. Chlorhexidine was associated with less catheter colonization (RR = –0.08, p = 0.0003). Few studies compared the use of alcohol, octenidine, hydrogen peroxide, and silver.
The findings suggest that skin antisepsis with chlorhexidine is most effective in reducing BSI; however, the overall quality of the evidence is very low to moderate.
Mostly low quality/high risk of bias studies
Chlorhexidine is generally more effective than povidone iodine or alcohol for skin antisepsis as part of catheter care for reducing catheter-related BSIs and catheter colonization.